Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 60676898 | WA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD179026 | OR |
NPI | 1245556984 |
---|---|
Provider Name | Penelope D Lang |
First Address | Portland, OR 97227-1196 |
Second Address | Portland, OR 97227-1196 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2010 |
Last Update Date | 01/02/2022 |